Clark Khaya D, Coco Laura, Zaugg Tara, DeFrancesco Susan, Kaelin Christine, Henry James A, Carlson Kathleen F
VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR.
Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland.
Am J Audiol. 2023 Nov 20:1-14. doi: 10.1044/2023_AJA-23-00040.
Tinnitus is highly prevalent among U.S. military Veterans, yet referral to, and use of, tinnitus rehabilitation services to improve quality of life and functional status with tinnitus is low. Veterans with tinnitus often have other health issues that overlap or exacerbate the impact of tinnitus, potentially complicating referral and rehabilitative pathways. This qualitative study explores views on the daily impacts of tinnitus and experiences with tinnitus-related health care among Veterans. The goal of this research is to amplify the voices of Veterans regarding their experiences with tinnitus to illuminate the physiological and socioemotional sequelae associated with the condition and to increase clinician awareness of the complex, interdisciplinary rehabilitative needs among Veterans with bothersome tinnitus.
This qualitative study was part of a larger study about tinnitus and traumatic brain injury (TBI). Veterans were sampled to represent national Department of Veterans Affairs (VA) users with and without comorbid TBI, and who were or were not interested in tinnitus rehabilitation services. Forty Veterans with tinnitus were interviewed (32 men, eight women). Data were analyzed using a modified grounded theory approach.
Major themes across the Veteran interviews included (a) functional effects of tinnitus on daily life, (b) tinnitus and other health conditions, (c) reactions to the lack of a cure for tinnitus, (d) strategies to improve quality of life and function, and (e) use of VA services for tinnitus.
Our findings highlight that bothersome tinnitus negatively impacted various aspects of daily functioning, including communication, sleep, concentration, and mood, suggesting a need for audiologists to work closely with mental health services to improve quality of life and functional status for those negatively impacted by the condition. Future work is needed to obtain the viewpoints of clinicians and other health care partners to better understand the barriers and facilitators to providing evidence-based tinnitus treatment in VA and non-VA settings.
耳鸣在美国退伍军人中极为普遍，但寻求并使用耳鸣康复服务以改善耳鸣患者生活质量和功能状态的比例较低。耳鸣退伍军人常常伴有其他健康问题，这些问题会叠加或加剧耳鸣的影响，可能使转诊和康复途径变得复杂。本定性研究探讨了退伍军人对耳鸣日常影响的看法以及与耳鸣相关的医疗保健经历。本研究的目的是放大退伍军人关于耳鸣经历的声音，以阐明与该病症相关的生理和社会情感后遗症，并提高临床医生对患有烦扰性耳鸣的退伍军人复杂的跨学科康复需求的认识。
本定性研究是一项关于耳鸣和创伤性脑损伤（TBI）的大型研究的一部分。对退伍军人进行抽样，以代表患有和未患有合并TBI的美国退伍军人事务部（VA）全国用户，以及对耳鸣康复服务感兴趣或不感兴趣的用户。对40名耳鸣退伍军人进行了访谈（32名男性，8名女性）。使用改良的扎根理论方法对数据进行分析。
退伍军人访谈中的主要主题包括：（a）耳鸣对日常生活的功能影响；（b）耳鸣与其他健康状况；（c）对耳鸣无法治愈的反应；（d）改善生活质量和功能的策略；（e）使用VA耳鸣服务。
我们的研究结果表明，烦扰性耳鸣对日常功能的各个方面都有负面影响，包括沟通、睡眠、注意力和情绪，这表明听力学家需要与心理健康服务机构密切合作，以改善受该病症负面影响者的生活质量和功能状态。未来需要开展工作，以获取临床医生和其他医疗保健合作伙伴的观点，以便更好地了解在VA和非VA环境中提供循证耳鸣治疗的障碍和促进因素。
